Formulation and evaluation of novel stomach specific floating microspheres bearing famotidine for treatment of gastric ulcer and their radiographic study

Objective:To develop and characterize multiple-unit-type oral floating microsphere of famotidine to prolong gastric residence time and to target stomach ulcer.Methods:The floating microspheres were prepared by modified solvent evaporation method,Eudragil S-100 was used as polymer.Microspheres were characterized for the micromeritic properties,floating behavior,entrapment efficiency and scanning electron microscopy.The invitro release studies and floating behavior were studied in simulated gastric fluid at pH 1.2.Different drug release kinetics models were also applied for all the batches.Selected formulations were also subjected for X-ray radiographic study.Results:Floating microspheres were successfully prepared by modified solvent evaporation technique.Microspheres showed passable flow properties.The maximum yield of microspheres was up to(95.11±0.35)%.On the basis of optical microscopy particle size range was found to be ranging from(52.18±182.00) to(91.64±5.16) μm.Scanning electron microscopy showed their spherical size,perforated smooth surface and a cavity inside microspheres.Microspheres were capable to float up to 20 h in simulated gastric fluid.X-ray radiographic studies also proved its better retention in the stomach.Conclusions:On the basis of the results,such dosage forms may be a good candidate for stomach targeting and may be dispensed in hard gelatin capsules.

Role of H2 receptor blocker famotidine over the clinical recovery of COVID-19 patients: A randomized controlled trial

BACKGROUND Coronavirus disease 2019(COVID-19)is a global pandemic putting the population at a high risk of infection-related health hazards,mortality and a potential failure of proper medical therapies.Therefore,it is necessary to evaluate the potential use of the existing drugs that could be used as options for the medical management of COVID-19 patients.AIM To evaluate the role of the H_(2) receptor blocker“famotidine”in COVID-19 illness.METHODS This study was done on seriously ill COVID-19 patients admitted to the intensive care unit(ICU)from different institutes in Bangladesh.Patients were divided into famotidine treatment group“A”(famotidine 40 mg to 60 mg oral formulation every 8 h with other treatment as given),and control group“B”(treatment as given).National early warning score(NEWS)-2,and sequential organ failure assessment day-1 score was calculated to evaluate the outcome.Outcomes were evaluated by the time required for clinical improvement,characterized as duration required from enrollment to the achievement of NEWS-2 of≤2 maintained for 24 h;time to symptomatic recovery,defined as the duration in days(from randomization)required for the recovery of the COVID-19 symptoms;mortality rate;duration of ICU and hospital stay;total period of hospitalization;the rate of supplementary oxygen requirement;the computed tomography(CT)chest recovery(%),the time required for the viral clearance and“NEWS-2”on discharge.RESULTS A total of 208 patients were enrolled in this study with 104 patients in each group.The famotidine treatment group had comparatively better recovery of 75%and a low mortality of 25%than the control with a recovery of 70%and a mortality of 30%.Duration of clinical improvement(group A 9.53 d,group B 14.21 d);hospitalization period among the recovered patients(group A 13.04 d,group B 16.31 d),pulmonary improvement in chest CT(group A 21.7%,group B 13.2%),and the time for viral clearance(group A 20.7 d,group B 23.8 d)were found to be statistically significant P≤0.05.However,the Kaplan Meier survival test was not significant among the two study groups,P=0.989.CONCLUSION According to our study,treatment with famotidine achieved a better clinical outcome compared to the control group in severe COVID-19 illness,although no significant survival benefit was found.

Efficacy of the H2-receptor antagonist famotidine on chronic spontaneous urticaria in children

Urticaria is a common pediatric skin disorder. Histamine H1-receptor antagonists are effective in chronic as well as acute urticaria. When H1-anti-histamines are ineffective, add-on use of H2-receptor antagonists is thought to give better symptom relief. However, there are few reports on the therapeutic efficacy in pediatric patients. We retrospectively reviewed the medical records of pediatric patients with chronic spontaneous urticaria (csU) who met the following criteria. They were consulted our outpatient clinic between April 2010 and March 2012;were unsuccessfully treated with H1 antihistamines;and were treated with add-on H2-receptor antagonist (famotidine). In six patients who met the inclusion criteria (mean age 6.1 ± 5.1 years), urticaria activity score was significantly decreased from 4.3 ± 0.8 just before administration of famotidine to 1.3 ± 1.0 on the first outpatient visit within 4 weeks after the first administration of famotidine

Analysis and monitoring of drug therapy in a patient with peptic ulcer complicated by infection:A case report

BACKGROUND The role of primary-level medical pharmacists in medical institutions in China is limited;therefore,it is necessary to explore the role of pharmacists in the process of drug treatment.CASE SUMMARY A Chinese pharmacist participated in the complete treatment of a patient with a duodenal ulcer.The rationale for drug treatment was evaluated,and adjustments were made to the antacid and anti-infective regimen,as well as the dose and frequency of administration.Body temperature,routine blood examination,and adverse drug reactions were strictly monitored.During treatment,the pharmacist recommended anti-infective therapy with ampicillin-sulbactam,which effectively controlled the infection.Additionally,the pharmacist suggested changing famotidine to lansoprazole for acid suppression and gastroprotective treatment,combined with Chinese patent medicine such as Kangfuxin Liquid.This is the first case report of a pharmacist in primary-level medical institutions adjusting drug use for patients with duodenal ulcer and pulmonary infection.CONCLUSION A pharmacist participated in the treatment process,provided individualized medication adjustment,and achieved good clinical results.

Functional dyspepsia of ulcer-dysmotility type:clinical incidence and therapeutic strategy

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Known drugs and small molecules in the battle for COVID-19 treatment

COVID-19 has been declared a pandemic by the World Health Organization on March 11th and since then more than 3 million cases and a quarter million deaths have occurred due to it.The urge to find a resultful treatment or cure is now pressing more than any other time since the outbreak of the pandemic.Researchers all over the world from different fields of expertise are trying to find the most suitable drugs,that are already known to treat other diseases,and could tackle the process of SARS-CoV2 through which it invades and replicates in human cells.Here,we discuss five of the most promising drugs that can potentially play a major role in the treatment of COVID-19.While nicotine and ivermectin may be blocking transport abilities of the virus or its components,famotidine,remdesivir and chloroquine in combination with zinc ions can deactivate important enzymes needed for the replication of the virus.While clinical trials for some of these drugs have already started,it is common knowledge that lack of organization between countries,institutes and hospitals might slow down the whole process for an official treatment based in wide,randomized,placebo controlled trials.